Systematic review of evidence for the benefits of telemedicine

Alberta Heritage Foundation for Medical Research, Edmonton, Canada.
Journal of Telemedicine and Telecare (Impact Factor: 1.54). 02/2002; 8 Suppl 1(suppl 1):1-30. DOI: 10.1258/1357633021937604
Source: PubMed


A systematic review of telemedicine assessments based on searches of electronic databases between 1966 and December 2000 identified 66 scientifically credible studies that included comparison with a non-telemedicine alternative and that reported administrative changes, patient outcomes, or results of economic assessment. Thirty-seven of the studies (56%) suggested that telemedicine had advantages over the alternative approach, 24 (36%) also drew attention to some negative aspects or were unclear whether telemedicine had advantages and five (8%) found that the alternative approach had advantages over telemedicine. The most convincing evidence on the efficacy and effectiveness of telemedicine was given by some of the studies on teleradiology (especially neurosurgical applications), telemental health, transmission of echocardiographic images, teledermatology, home telecare and on some medical consultations. However, even in these applications, most of the available literature referred only to pilot projects and to short-term outcomes. Few papers considered the long-term or routine use of telemedicine. For several applications, including teleradiology, savings and sometimes clinical benefit were obtained through avoidance of travel and associated delays. Studies of home care and monitoring applications showed convincing evidence of benefit, while those on teledermatology indicated that there were cost disadvantages to health-care providers, although not to patients. Forty-four of the studies (67%) appeared to have potential to influence future decisions on the telemedicine application under consideration. However, a number of these had methodological limitations. Although useful clinical and economic outcomes data have been obtained for some telemedicine applications, good-quality studies are still scarce and the generalizability of most assessment findings is rather limited.

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    • "During the past two decades, many broad reviews of telemedicine have been published, describing the state of knowledge and assessing – to some extent – the quality of the evidence at hand. Some reviews are wide ranging both in scope and geography [1], [2], some are broad in scope but restricted to some countries [3], some deal with specific perspectives of application (like diagnostic and management decisions) [4], [5], and rare ones look at costs [6]. Two recent systematic reviews added to the literature in this area: one assessed the effect of telemedicine on professional practice and on patient health care outcome [7] and the other was a systematic review of reviews about the effectiveness of telemedicine [8]. "
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    • "This includes the delivery of medical care services, diagnosis, consultation, treatment, as well as health education and the transfer of medical data " [1]. In 1906, Wilhelm Einthoven experimented the first telemedicine by transmitting electrocardiogram (ECG) recordings through telephone [2] [3] [4]. Since then, telemedicine has become routine practice for specialists to review remote patients' radiology and neurosurgery image [5] [6]. "
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